| Ambulatory blood pressure, endothelial perturbation, and microvascular complications in type 2 diabetes. | |
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MedLine Citation:
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PMID: 21219847 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Diabetic vascular complications constitute leading causes of blindness, renal failure, and cardiovascular morbidity and mortality world-wide. We studied haemodynamic and structural abnormalities associated with the development of microvascular complications and evaluated the effect of intervention with antihypertensive agents on these risk factors and complications in type 2 diabetic patients (T2DM). Retinal thickness, urinary albumin excretion rate, and transcapillary escape rate of albumin were strongly associated in T2DM patients with maculopathy, suggesting that macular oedema is a marker of generalised vascular hyperpermeability in T2DM. Plasma from T2DM patients with maculopathy stimulated the expression of E-selectin in cultured endothelial cells. Reduced nocturnal blood pressure decline ("non-dipping") and elevated pulse pressure (PP) were associated with micro- and macrovascular complications and predicted progression of nephropathy in T2DM subjects. Non-dipping and elevated PP were associated with increased plasma levels of markers of endothelial activation in T2DM patients, suggesting that endothelial perturbation could represent a pathophysiological link between these haemodynamic risk factors and the development of vascular complications in T2DM. 4 months treatment with losartan 50 mg o.d. did not ameliorate macular oedema in T2DM patients with maculopathy. 12 months dual blockade of the renin-angiotensin system with candesartan and lisinopril reduced ambulatory PP levels compared with high-dose lisinopril monotherapy in hypertensive T2DM subjects. |
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Authors:
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Søren Tang Knudsen |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Danish medical bulletin Volume: 57 ISSN: 1603-9629 ISO Abbreviation: Dan Med Bull Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2011-01-11 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0066040 Medline TA: Dan Med Bull Country: Denmark |
Other Details:
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Languages: eng Pagination: B4145 Citation Subset: IM |
Affiliation:
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Medical Department, Regional Hospital Silkeborg, Falkevej 1-3, 8600 Silkeborg. Denmark. stk@dadlnet.dk. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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